Cognitive status and anxiety level in patients with arterial atherosclerosis in the perioperative period

   Background. The course of arterial atherosclerosis, especially against the background of an increase in the biological age of a person, is associated not only with severe disorders of somatic, but also cognitive status. Conducting operations aimed at restoring blood circulation is associated with the progression of cognitive impairment or the appearance of postoperative cognitive dysfunction.

   Objective. To determine the incidence and dynamics of cognitive impairment and anxiety in patients with arterial atherosclerosis in the perioperative period.

   Design and methods. The study included 60 patients with arterial atherosclerosis admitted for planned surgical interventions to the cardiovascular surgery department. The main surgical interventions were carotid endarterectomy and reconstructive operations on the arteries of the aortofemoral-tibial segments. Depending on the initial cognitive status, the patients were divided into two groups: A — 38 patients with cognitive impairment and B — 22 patients without cognitive impairment. The primary neuropsychological examination was conducted 24 hours. Repeated diagnostics were performed by a neuropsychologist on the 5–7^th day after the operation. General data of the patients, the structure of the primary and concomitant diagnoses, and the operations performed were studied. Neuropsychological diagnostics included the Montreal Cognitive Assessment Scale (MoCA), the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and the Spielberger-Khanin test.

   Results. Patients in Group A had signs of cognitive dysfunction, the average MoCA test score was 21.9 ± 3.4 points, versus 27.4 ± 1.2 points in Group B. Most patients in Group A were diagnosed with carotid artery atherosclerosis, arterial hypertension, and coronary heart disease. Multiple correlations were found, confirming the influence of factors on the cognitive status and anxiety level of patients.

   Conclusion. The study found that 38 (63.3 %) patients were diagnosed with cognitive decline for the first time in the preoperative period. The main factors that lead to cognitive deficit are old age, carotid artery atherosclerosis, high comorbidity, social and work status.

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